News & Notes

Patients' Rights Bill Passes House

By a margin that surprised supporters and opponents alike, the House of Representatives on October 7 passed the a bill to expand significantly the rights of patients in their dealings with HMOs.

The Senate passed a more limited patients' rights bill in July, and the next step is a House-Senate conference to reconcile the two versions. The two bills differ in several ways, among them:

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The House bill would apply to 161 million people, while the Senate version would apply to only 48 million.

Under the House bill, patients would have the right to sue, in federal or state courts and for unlimited damages, HMOs that cause injury by denying or providing substandard care . The Senate version lets stand a federal ban on lawsuits by individuals in health plans that fall under federal regulation. (Earlier in the day, the House rejected by a vote of 238 to 193 an alternative bill offered by Republicans that would have given patients a limited right to sue HMOs in federal court.)

In the House version, health plans would be required to pay routine healthcare costs associated with clinical trials, except trials funded by the FDA. A similar provision in the Senate bill would apply only to cancer patients.

The 275-to-151 vote included a stunning 68 Republicans who defied their party's leadership and voted for the bill. Republican opposition to the bill, backed by a well-financed coalition of insurance companies and businesses, centered on the right-to-sue provision, claiming that it would lead to an avalanche of litigation. Proponents argued that it would lead to better care, giving fewer patients grounds for lawsuits.

The House bill was authored by Representatives Charlie Norwood (R-GA), a dentist, and John D. Dingell (D-MI) and, predictably, supported by consumer advocates and labor unions. They found allies in doctors and nurses, who have rebelled against HMOs undermining their professional judgment and autonomy. Among the most vocal proponents of the stronger House version of the legislation were the American Medical Association and Representative Greg Ganske (R-GA), a surgeon.

Supreme Court To Hear ADA Case

In a case that could have important implications for people with HIV/AIDS, the U.S. Supreme Court is set to address the question of whether an individual who files for Social Security disability benefits forfeits the protections of the Americans with Disabilities Act.

The case is Carolyn Cleveland v. Policy Management Systems. Cleveland, whose 1994 stroke had left her with medical problems and a speech impediment, requested and was denied reasonable workplace accommodations and was fired from her job. Her employer, Policy Management Systems, claims that she is not entitled to ADA protection from discrimination because she has filed for Social Security disability.

The Lambda Legal Defense and Educational Fund has entered the case as amicus on behalf of 48 major medical, public health, disability, and civil rights organizations.

HIV University

Women from ten cities across the United States gathered in San Francisco in September to participate in HIV University, a unique peer-based treatment education training program created by WORLD (Women Organized to Respond to Life-threatening Diseases), a community-based organization located in Oakland, California. The program provides participants with the needed skills to implement an HIV University, created by women, for women with and/or affected by HIV, in their own communities.

Teams of two women each came from Baltimore, Maryland; Chicago, Illinois; Cleveland, Ohio; Conyers, Georgia;, Los Angeles, California; Monroe, Louisiana; Orlando, Florida; Phoenix, Arizona; Queens, New York; and San Antonio, Texas, to participate in the week-long training program. The women who took part have experience as HIV advocates, educators, and consumers, and have demonstrated an outstanding commitment to helping other women with the disease. The training program provided them with information on how to obtain funds for their programs, publicize the programs to encourage enrollment, and facilitate group discussions about living with HIV.

"The HIV University training program provides team leaders with the resources and knowhow to develop a successful program in their own communities," said Marina Alvarez, who is on the planning committee for the HIV University training program. "These dedicated team leaders serve as role models for the women enrolled in their local HIV University."

HIV University is designed to have a positive impact on the lives of women with HIV by providing them with a vital support network in their own geographic areas and with the information they need to manage their illness. After completing the training in San Francisco, team leaders are responsible for recruiting participants from their communities and for facilitating discussions in which participants set their own curriculum based upon the interests and needs of group members. Sessions may cover information about managing HIV, family concerns, legal issues, and treatment of the disease.

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